Psychosocial Outcome of Craniofacial Surgery in Children

Abstract

Anecdotal accounts of patients with craniofacial anomalies have described major psychosocial difficulties. It has been assumed that these individuals are ostracized from society and suffer profound psychological disturbance from consistent societal and perhaps even familial rejection. In a recent study we assessed psychosocial functioning of children aged 6–13 with congenital craniofacial malformations. This investigation demonstrated that relative to a matched comparison group the children with craniofacial anomalies had poorer self-concept, greater anxiety at the time of evaluation, and more introversion. Their parents reported more frequent negative social encounters for the children and more hyperactive behavior at home. Their teachers reported more problematic classroom behavior. The extent of these deficits was limited. While the children with craniofacial anomalies did not appear to be performing quite as well as the healthy comparison children, they were generally not functioning in a psychosocially deviant range. In the present study, we evaluated the same group of patients an average of 18 months postoperatively and similarly followed up the comparison group.